子宫肌瘤的超声诊断与鉴别诊断

The diagnosis and differential diagnosis of hysteromyoma by ultrasound

目的:探讨子宫肌瘤的声像图特征以及诊断与鉴别诊断,以提高诊断准确率。方法:对上海中山医院青浦分院采用Acuson超声诊断仪2009～2011年诊断的213例子宫肌瘤(经腹部探测),进行对病灶的部位、大小、形态、回声特征的监测及部分患者术后的随访观察。结果:213例患者中肌壁间肌瘤128例,浆膜下肌瘤56例,黏膜下肌瘤10例,混合性肌瘤19例。经随访,手术治疗的78例,其中病理符合76例、符合率达到97.4%左右,1例误诊(病理为子宫肌腺症)、1例漏诊(病理为妊娠合并肌瘤),误诊率为1.3%。结论:超声可动态观察子宫肌瘤的声像图特征,具有方便快捷、误诊率低、无创伤等特点,是临床首选检查,在子宫肌瘤的诊断、治疗及术后随访方面起着相当重要的作用。

Objective： To explore the hysteromyoma uhrasonographic feature and the diagnosis and difterential diagnosis, in order to improve the diagnostic accuracy. Methods： 213 cases of hysteromyoma diagnosis in Shanghai Zhongshan Qing-pu Affiliated hospital were chosen and were diagnosed,by the ultrasonic diagnostic instrument acuson during 2009-2011 （detection through the abdomen）, the focus position, size, shape, echo characteristics were monitored and some patients were followed up. ]Results： Among 213 cases, muscle intramural fibroids 128 cases, subserosal fibroids 56 cases, submu- cosal fibroids 10 cases, mixed fibroids 19 cases. The surgical treatment of 78 patients, pathology were 76 cases, the coinci- dence rate was 97.4%, and 1 case was misdiagnosed （pathological for abenomyosis）, 1 case was missed diagnosis （pathologi- cal for pregnancy with fibroids）, the misdiagnosis rate was 1.3%. Conclusion： Dynamic ultrasound can observe the hys- teromyoma ultrasonographic feature, with convenient and quick, low misdiagnosis rate, no wound, it is the best choice of clinical examination, it plays a very important roleuterine in fibroids diagnosis, treatment and postoperative follow-up.